Paper short abstract:

By comparing the uses of QALY and DALY in Global Health, this paper discusses how differences in measurement of health organize, perform and reproduce geo-politically situated differences in the value of human life.

Paper long abstract:

This paper discusses the role of difference in the configuration of knowledge infrastructures in Global health and their consequences in the valuation of human life and health. Differences in measurement of health organise, perform and reproduce differences in the value of life that are geopolitically situated. By comparing the design, controversies and practical uses of health adjusted metrics: Quality Adjusted Life Years (QALY) and Disability Adjusted Life Years (DALY) this paper explores the margins of the valuation of human life in healthcare policy and decision-making. Despite its universalistic rhetoric, the value of human life depends on the social practices and material infrastructure that make possible its calculation. A comparative approach to these practices shows asymmetries in valuation that recreate geopolitical, social and healthcare segmentations, for instance between developed and developing countries, North and South, the rich and the poor, communicable and non communicable disease. STS recently has shown an increasing interest in understanding the consequence of quality of life metrics in the shaping of contemporary healthcare (Sjögren and Helgesson, 2007; Moreira, 2012; Wahlberg and Rose, 2015; Kenny, 2015), this paper contributes with such works by showing the tensions, asymmetries and contradictions that these metrics entail. This paper empirically traces the ways in which differences in calculation and measurement are key elements to understand the exclusions that global health knowledge infrastructures create in terms of production of value.